Letter About Lobby Day

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Email not displaying correctly? View it in your browser. We Are Advocating For You! On May 17th, 2011, I joined Physical Therapists from around the state for our annual Lobby Day.  It's a unique opportunity to visit with our state legislators and/or their staff directly in their Albany offices.  We advocate for various Physical Therapy related health care delivery and accessibility related bills that have been sponsored by various legislators from across the state.  It's a time to share with them both the perspectives we have as the PT's who deliver a valuable service to you all, but also to share with them the frustrations, concerns, and needs that many of you have expressed to us.    Our local Finger Lakes District (of the NY Physical Therapy Association) contingent met with representatives from the areas we live and work in.   For example, I live in Irondequoit so I met with Assemblyman Morelle, who also holds the very important position of Chair of the Insurance Committee.  I also joined the group that visited with Assemblyman Mark John, whose region includes East Rochester, where Peak Performance PT is located.  I was part of a very large group that also met with Senator Robach, who Chairs the Labor Committee in the NYS Senate.  Senator Alesi was visited by one of our Finger Lakes District PT's earlier in the day before our bus arrived.   We literally had meetings scheduled every 30 minutes all day long from 9 a.m. through 3:30 p.m.  It's very interesting to see how the process in Albany works and to hear more about how bills move through the legislative system in NYS and to hear of some of their own frustrations about the process as well.    One thing is for sure...while we all often feel that special interest groups and the "deepest pockets" rule the land, it is crucial for legislators to hear from their district's voters.  Ultimately, they only remain in office if they are voted back in.  When you have an issue or concern with something they can help with or that their vote impacts then it is imperative you contact their office directly or write a note so they know your feelings.  If they are not hearing from you and other voters on an issue then their impression is that the problem is not really even on the radar screen, so to speak, or at least that it's not as big a concern as some "special interests" would have them believe.  They need to hear from you!    Here's a summary of the bills that we discussed with our local NYS Legislators.  If you have strong feelings about these, especially regarding how these issues affect your ability to access quality health care at reasonable costs then please, please, please make sure to contact your representative to let them know how you feel.  There are still six weeks left in this session before they take their summer break.  You can make a difference!   High Co-Pays Bill (Assembly A0187-Sponsor: Cahill/Senate Bill 4870-Sponsor: DeFrancisco) The changes in health insurance over the years resulted in a system where co-pays are deemed either Primary Care or Specialist.  There can be only one "Primary Care" doctor listed on your plan and so ALL others receive this "Specialist" distinction.  As the delivery of health care has changed over the years the Primary Care Physician's role was promoted - a component of that  was to  reduce unnecessary frequent visits to specialists such as Cardiologists or Orthopedists - thus your Primary Care co-pays are much less than for Specialists.  As the years have gone by more recently we have seen the discrepancy between these two tiers grow and grow - for some the Specialist co-pay is even at $50.    For an infrequent visit to a Physician Specialist/Surgeon the $50 co-pay will not typically discourage you to obtain proper health care.  For PT's it is a much different story, as you well know.  We've had many patients reduce their visit frequency or just decide not to do PT because of the high co-pays.  Physical Therapy is one of the few health care services requiring frequent or recurring visits, very much unlike other typical "Specialists" like a Cardiologist or Orthopedic Surgeon - who you might see a few times in a year or whose follow up visits are spread out by 4-6 weeks and not by just a few days.    Also, the percentage of the visit cost that is actually being paid by the patient (you!) is significantly greater in the case of that PT visit for $50 versus your Cardiologist or Orthopedists's visit fee.  That means the actual "benefit" amount paid by your insurance company toward that service is less in the case of Physical Therapy.    And, a really important fact to know is that there are a number of very good studies that have been conducted that show early access to Physical Therapy can significantly improve outcomes and reduce the overall cost of care.  That seems hard to argue with...BETTER OUTCOMES + REDUCED COSTS - but high co-pays continue to threaten the ability of consumers to easily access Physical Therapy.   This bill seeks to limit the co-pay amount to a cap of 20% of the reimbursement for a PT session, which is on par with the existing Medicare guidelines.     Worker's Compensation PT Assistant Bill (Assembly Bill A7308-Sponsor: Canestrari, Senate Bill S5005-Sponsor: Griffo) Our NYS Practice Act licenses Physical Therapy Assistants to deliver PT services under the supervision of a licensed Physical Therapist.  Oftentimes you find the same sort of set up in your Physician's offices right - you might see a Physician Assistant or Nurse Practitioner instead of the actual Physician.  While the laws governing each professional differs some, the fact is that each is considered an "extender" of the main professional - the Physician or the Physical Therapist.    While in NYS Physical Therapy Assistants are licensed to practice, the Worker's Compensation system does not recognize their use and will not reimburse for PT services delivered by a PT Assistant.  This bill merely seeks to have the WC guidelines fall into line with its own existing NYS laws that allow PTA's to work with PT's in the delivery of care, allowing reimbursement for their services of WC patients.  It seems silly to even have to ask for this to be a bill - but somehow an interpretation of language in prior guidelines has caused our own NYS Worker's Comp system to not follow the actual NYS Practice Act guidelines that exist.  Go figure.     Worker's Compensation Fee Schedule Bill (Assembly Bill A7356-Sponsor: Canestrari, Senate Bill S5090-Sponsor:  Griffo) Did you know that the last time NYS adjusted the rates of payment for Physical Therapy services was over 15 years ago?  Think of your own pay...what if your pay rate hadn't changed in 15 years?    We are seeing PT's in NYS begin to drop Worker's Compensation because they just cannot afford to accept such low reimbursement based on the "cost of doing business" associated with each case.  The accessibility of WC patients to PT care is being affected.  NY reimburses Physical Therapy at one of the very lowest rates in all 50 states.  There are nearby states who reimburse 2-3x of what NYS does.    Consider that only pennies on the dollar of Worker's Compensation money is going to pay for Physical Therapy itself, the very thing that is helping to get the injured worker safely back to gainful employment.  And remember that there are quality studies that show the earlier return of function and COST SAVINGS associated with early access to quality Physical Therapy compared to waiting or compared to other forms of health care.    I know this is going to sound funny - but this bill only seeks to ask the Worker's Compensation Board to formally REVIEW the fee schedule every two years.  It doesn't even ask for a raise in the actual rates.  We've had such a difficult time getting answers from the WC Board that this bill was introduced to at least require them to review the Physical Therapy fee schedule.     Increased Educational Requirements Bill (Assembly Bill A2502-Sponsor:Canestrari, Senate Bill S3469-Sponsor:  Oppenheimer) NY is the last state in the nation allowing PT's with a BS degree to sit for licensure exams.  All of the academic programs in both NYS and across the nation have already moved to Master's level and now most often are Doctorate level programs.  There are no Bachelors programs for Physical Therapy left in the United States.  What we see happening is that since NYS is the ONLY state in the U.S. allowing Bachelor's degreed PT's to sit for licensing, there has been an influx of foreign trained PT's with this lesser academic training that is below the existing standard that presently exists in NYS (and the U.S.) coming to take licensing exams here.  Once licensed, they can then move to other states to obtain licensure there and practice.    This bill actually would raise the licensure exam requirement to an advanced "post-baccalaureate" level degree (ie: Master's or Doctorate) in order to be in line with the existing academic programs across the state.    That's a pretty simple one.   SUMMARY There are bills that have been drafted and sponsored by various legislators across the state who support your access to health care and who recognize the value of Physical Therapy, not only as a profession in general but as a valuable and economical means of providing necessary rehabilitation care to you.  There are a number of hindrances that exist within our present system that negatively impact your access to PT, including high co-pays among the most important of these.    Know that whichever side of the line you stand on that YOU DO MAKE A DIFFERENCE.  Your "one voice" is significant because you are a voter and these NYS Legislators represent you...they care about how you feel.  But your "one voice" is amplified when each of you looks at a matter, comes to a decision as to how you feel about it, and voices that opinion to your local legislators.  If everyone sits and thinks that some other person will make the call or write the letter, then you risk your voice never being heard!  And the truth is...once you actually ACT and make that call or write that letter to your Assemblyperson or Senator then you have a story to tell, and when talking with friends or family you will inspire them to consider the facts and make their own voice heard.  Only then will our elected officials truly hear "the voice of the people" - and your actions will have made it that much harder for your opinion to be squashed under the weight of campaign dollars and rhetoric from "special interests".   Think about the bills I've shared with you and let your legislators know how you feel on them.    You can find out who your legislators are and how to contact them by the following link http://assembly.state.ny.us/mem/?sh=search . Remember that both the State Assembly and State Senate each have versions in their "house" to consider, so they both would need calls.  And, remember that the first hurdle is always getting the bill "out of committee".  The whole legislature never hears both sides of the story or votes on any bill until it is "out of committee" and on the floor for all to hear about.    Thanks for taking the time to learn about how NYS laws affect your health care and I hope you'll consider their merit and let your representatives know how you feel once you've come to a decision as to the merit of each of these.   Respectfully Yours,   Mike Napierala Peak Performance Physical Therapy 585-218-0240   *|IFNOT:ARCHIVE_PAGE|* *|LIST:DESCRIPTION|* *|END:IF|* Unsubscribe *|EMAIL|* from this list. *|IFNOT:ARCHIVE_PAGE|* Our mailing address is: *|HTML:LIST_ADDRESS_HTML|* *|END:IF|* Copyright © *|CURRENT_YEAR|* *|LIST:COMPANY|* All rights reserved.   Forward this email to a friend Update your profile *|IF:REWARDS|* *|HTML:REWARDS|* *|END:IF|*